You are growing up. One thing you need to consider is when to see a gynecologist or other women's health professional.

A gynecologist is a doctor who deals with systems and organs unique to females - the uterus, vagina and ovaries. This care also can be provided by your primary care physician, a nurse practitioner or physician assistant at your doctor's office or at a family clinic.

The Right Time

Every person is different, so it is not possible to say exactly at what age you should make your first visit to the gynecologist. Your parents or a guardian are often the best people to give you some guidance on this.

A good rule of thumb is to arrange a first visit when you are thinking about becoming sexually active or within 2 years after you begin your period. Of course, you should see someone right away if you are experiencing any problems, such as heavy bleeding, unusual discharge, pain, cramping or prolonged bleeding.

Why & How?

Typically, you would not have a physical exam on the first visit, unless you are there because of a problem. That first visit is your opportunity to get to know the healthcare professional and develop a relationship with that person. You can ask questions and go over your medical and sexual history at that time.

The healthcare professional may give you educational information on pregnancy, sexual activity and sexually transmitted diseases, and may discuss whether you should receive a vaccine called Gardasil, which would protect you against HPV (human papillomavirus), a sexually transmitted disease that in some cases can cause cancer.

If you made the appointment because you have a problem, you should expect to spend some time with the healthcare professional talking about your situation before you go into the examining room.

The Examination

When you do have an exam, ask the healthcare professional to explain the process so there are no surprises. You can expect the following to happen.

• You will completely undress privately and put on an examination garment.
  
• A nurse or other healthcare professional will support you during the exam.
  
• The healthcare professional will examine your breasts for any abnormalities.
  
• For the internal exam, you will place your feet in stirrups at the end of the table. The doctor will ask you to "scoot" down the table.
  
• A device called a speculum will be placed in your vagina that stretches the opening, allowing the physician to see the cervix.
  
• With a tiny spatula or brush, cells from your cervix will be collected and placed into a vial to be checked under a microscope in a laboratory for any abnormalities. Called a Pap smear, this is not painful. Some physicians recommend if you are sexually active with multiple partners to have a Pap smear done as soon as you become sexually active. Others suggest about 3 years after first sexual intercourse or by age 21, whichever comes first.
  
• After the speculum is removed, the healthcare professional may insert a finger into your vagina and press down gently with the other hand over your stomach to feel for any abnormalities.
  
• At the end, you will sit up and the healthcare professional can tell you the results of the physical part of your exam; lab results will come later.

Keep in Mind

If you are uncomfortable or feel pain at any time during the exam, tell the healthcare professional and he or she will stop the exam. However, this type of exam is usually quite painless.

No one likes undressing and being asked to expose her genitals. But remember, regular cervical and breast exams are important to your health as a woman.

Sources: Ronald Clauhs, MD, retired ob/gyn, West Chester, PA; American College of Obstetricians and Gynecologists, www.acog.org

Gail O. Guterl is editor at ADVANCE.